| Summary: | Objective. Aminothiols (glutathione (GSH), cysteinylglycine (CG)) may play an important role in the pathogenesis of coronavirus disease 2019 (COVID-19), but the possible association of these indicators with the severity of COVID-19 has not yet been investigated. Methods. The total content (t) and reduced forms (r) of aminothiols were determined in patients with COVID-19 (n=59) on admission. Lung injury was characterized by computed tomography (CT) findings in accordance with the CT0-4 classification. Results. Low tGSH level was associated with the risk of severe COVID-19 (tGSH≤1.5 μM, mild vs. moderate/severe: risk ratio RR=3.09, p=0.007) and degree of lung damage (tGSH≤1.8 μM, CT<2 vs. CT≥2: RR=2.14, p=0.0094). The rGSH level showed a negative association with D-dimer levels (ρ=−0.599, p=0.014). Low rCG level was also associated with the risk of lung damage (rCG≤1.3 μM, CT<2 vs. CT≥2: RR=2.28, p=0.001). Levels of rCG (ρ=−0.339, p=0.012) and especially tCG (ρ=−0.551, p=0.004) were negatively associated with platelet count. In addition, a significant relationship was found between the advanced oxidation protein product level and tGSH in patients with moderate or severe but not in patients with mild COVID-19. Conclusion. Thus, tGSH and rCG can be seen as potential markers for the risk of severe COVID-19. GSH appears to be an important factor to oxidative damage prevention as infection progresses. This suggests the potential clinical efficacy of correcting glutathione metabolism as an adjunct therapy for COVID-19.
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